As if you needed another reason to save, retirees in the U.S. can expect to live longer than those in other advanced economies, a new report on health concludes. But hold the champagne. There’s precious little else in the findings to celebrate.

American seniors benefit from lower cancer death rates and greater control of blood pressure and cholesterol levels, according to U.S. Health in International Perspective, a 378-page study by a panel of experts convened by the Institute of Medicine and the National Research Council. Seniors also enjoy one of the world’s most technologically advanced health care systems, made more affordable through Medicare after age 65.

So all that advice about planning your finances as though you’ll live to 90 rings true. A 65-year-old couple has a 45% chance of at least one of them living that long. According to the report, Americans start outliving people in peer countries after the age of 75.

The hard part, it seems, is getting to 75. When looking at life expectancy from birth, the U.S. is losing ground. A key finding was that Americans under 50 die earlier and live in poorer health than their counterparts in peer nations; and that they have far higher rates of death from guns, car accidents, and drug addiction. From the report:

“For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This disadvantage has been getting worse for three decades, especially among women. Not only are their lives shorter, but Americans also have a longstanding pattern of poorer health that is strikingly consistent and pervasive over the life course.”

The health disadvantage is pervasive, affecting all age groups up to age 75. The authors also cite lifestyles that limit physical activity and poor eating habits, issues that cut across economic classes.

Americans’ life expectancy has surged in the past 100 years. Today, an infant boy can expect to live to 76; a girl, 81. Yet of 17 advanced countries in the study, the U.S. ranks last in life expectancy at birth, trailing the leaders by four or five years.

Dan Kadlec is a journalist who has written about personal finance for TIME and other outlets for 25 years. He is the author of three books, a leading voice in the global financial literacy movement, and strategic adviser to the National Financial Educators Council.

Kadlec's latest is A New Purpose: Redefining Money, Family, Work,Retirement, and Success